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The sunny fact that Americans are living longer, more productive lives has a dark side: More of
us than ever live with chronic illnesses that are not only a drag on sufferers’ time and energy but
also on the nation’s pocketbook.

The Institute of Medicine recently put a dollar figure on the cost of caring for chronic illness
in the United States — $1.5 trillion yearly, fully three-fourths of annual health-care
spending.

Among the chronic health conditions on the American medical landscape, nine dominate, the
Institute of Medicine report says. The nine conditions, along with the estimated number of
Americans affected, are:

• chronic pain, 116 million adults

• arthritis, 50 million

• hearing loss, 34 million

• Type 2 diabetes, 25.6 million adults

• vision loss, 25 million

• depression, 20.3 million

• cancer survivorship, 12 million

• dementia, 5.4 million

• schizophrenia, 2 million

• post-traumatic disability, unavailable

Most of these chronic conditions are related to at least one of two factors clearly on the rise
among Americans: advanced age and obesity. So the prevalence of virtually all of these “big nine”
health conditions is also expected to rise in the years ahead.